This is the first report of AFS which caused frontal lobe symptomatology and which resolved with surgical therapy. The surgical approach used provided excellent exposure and the sinuses could be examined and thoroughly cleaned both from above and intranasally. The dural defect, which resulted from the destruction of the cribiform and fovea ethmoidalis, was easily reconstructed with a pericranial flap. This exposure facilitates debridement and reconstruction while minimizing complications such as cerebral spinal fluid leakage or brain injury which may occur with endoscopic manipulations in patients with bony destruction and loss of normal landmarks.
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